Summary Oral carcinogenesis is a multifactorial process involving numerous genetic events that alter normal functions of oncogenes and tumor suppressor genes. It is well established that an accumulation of genetic alterations is the basis for the progression from a normal cell to a cancer cell, referred to as multi-step carcinogenesis. This event may be increased the production of growth factors or the number of receptors on the cell surface, and/or increased transcription factors or intracellular signal messengers, further that associated with deregulated control of cell proliferation and apoptosis. Together with the loss of tumor suppressor activity, these changes lead to a cell phenotype that can increase cell proliferation, with loss of cell cohesion, and infiltration to adjacent tissue thus causing distant metastasis. Molecular medicine is responsible for defining the molecular mechanisms that underlie the onset of oral cancer. This review focuses on recent advances in our understanding of the molecular control of the innumerable pathways related to these processes. These may lead to short- or medium term improvements in the diagnosis and prognosis of oral cancerous lesions and to the development of novel therapeutic approaches to this disease.